I work at an ASO. A few co-workers and I were discussing what the best advice to give is in the following situation: someone who is HIV+, meets someone on the internet or at a bar, it will clearly be a one time hook up, how do they tell them they are positive? Obviously, we stress avoiding these sorts of encounters but we all know people will do what they do. Any suggestions on ways to do it with minimal backlash?

Thanks in advance. Love your forums!

Response from Dr. Frascino

Hello,

Disclosure is never easy and the decision how and when to reveal one's HIV status is different for every individual person and every individual situation. The general rule is the longer one waits to disclose his or her status, the harder it becomes. Another general rule is that it's best to disclose before having sex. In fact, depending on where one lives, it may even be illegal not to disclose before sex! As for the "one time hookup", how do you know in advance it will only be a one-time thing? What if you really click or if the sex is so cosmically fabulous, you want a repeat performance? The ultimate bottom line, if you conveniently forget to disclose, is that it is your personal responsibility to ensure that you have safer sex.

I'll repost some questions and my response form the archives that discuss disclosure issues.

Stay well.

Dr. Bob

What a way to disclose.

Oct 24, 2005

I have known of my HIV status for about four years now, however I sometime have this issue of disclosing to my patners at the right time. Sometimes I feel I disclose to early and sometime I feel I disclose too late. On October17, 2005 my current boyfriend and I had intercours and the condom broke. As he got up he annouced the news of " the condom broke" and he thought nothing of it. I immediately felt scared to the point that I cried. I notice on the bed sheets there were blood ( just slight but it was blood). I went to work and thought about what should I do. I made a few calls and before you know it we were on our way to the ER for PEP perscription. On the way there I had to disclose to him that he has been exposed to the virus and we are on our way for you some help. My question is, what is his chances of contracting the disease and how can I keep this man in my life, I love him so much and I don't want to lose him. Oh we have been together for about a month in a half now.

Response from Dr. Frascino

Hello,

When to disclose is a question many of us wrestle with on a continual basis. I'll repost below some responses from the archives that address this topic.

Regarding your questions of the risk of acquiring HIV from the broken-condom experience, you did not mention if your partner was insertive (top) or receptive (bottom). So I'll give you the estimated risk statistics for both. The estimated per-episode risk for acquisition of HIV from unprotected (including broken condom) insertive anal intercourse is 6.5 per 10,000 exposures to an infected source. This estimated risk increases to 50 per 10,000 exposures for receptive unprotected anal sex with a positive partner. These risks would decrease if PEP is taken.

How can you keep this man in your life? Communication is key. Why not show him this post? Your concern and compassion for him are clearly evident in your comments.

I wish you both good luck.

Dr. Bob

Feel Really Bad Jul 12, 2005

Dr. Bob,

I am an HIV poz male of five years, I try to make sure I have safe sex for the most part. I placed an ad, where it asks you if you are neg or poz, or you do not have to answer, I choose not to answer, and instead have that conversation with a person when sex is a possibility. However, I met this guy, we had dinner and a few glasses of wine, and I spent the night, however during the night he started to have aggressive sex with me that lead to unprotected sex, this is someone I do not know his status. I am a wreck, he stated he had diarrhea for a few days, and a pain in is throat, I was tested two weeks ago, have not had sex with one else, and don't have any std's... I know I have to bring this subject to the table, please help me out..

Jim

Response from Dr. Frascino

Hi Jim,

The subject of when and how to disclose your HIV status is not an easy topic to address, as there is no easy (or correct) answer for everyone's unique situations. Jim, I think you already know what needs to be done, and I would add the sooner the better. I'll post several of my responses from the archives that address the disclosure issue.

Good luck,

Jim.

When to dislcose Mar 28, 2004

Hi Dr. Bob,

Thanks for your helpful insight for us pozitoids. I have been positive for a little over a year now. I have only dated one guy since and he was also positive. That lasted for about six months as I was not ready emotionally to be involved with someone so soon after my diagnosis. Well here it is a year later and I have met a great guy. We met at a club a few weeks ago. We have not had sex yet. We have however kissed passionately on several occaisions. I am going to be spending the weekend with him next week and it will definitely be time to perform. We have not even broached the subject yet of HIV. I am very interested in this guy and am wondering when I should tell him. I know it will be before we get in the sack. But I am wondering if it would be best at dinner, after dinner...This is the first time I have had to disclose to a guy since my diagnosis, not knowing what his status his, his feelings about HIV etc. (I met the guy I dated immediately after my diagnosis through a positive group). So I am totally new with this disclosure thing. Any insight you could give me about what to say and when to say it would be greatly appreciated. Your experiences as a fellow positoid are refreshing and greatly reasurring.

Thanks again.

Response from Dr. Frascino

Hi,

I recently posed the "when do you tell a potential bed partner you're positive" question to a group of pozitoids. The answers ranged from "pre-smooching" to "pre-heavy petting" to "before the money shot" to "afterward" to "I usually don't even tell 'em my name!" so, you can see, there really was no consensus here whatsoever! As for my personal opinion, I addressed this topic recently in another question, so I'll just re-copy that post and hope it helps your decision process.

Good luck.

Dr. Bob

help,i feel like a deadly weapon Posted: Mar 18, 2004

Dear sir,

several times i foloowed your forums and answers you have given to many other people here. I'm really in crazy mood and i beg you tell me something about the follow situation.I'm very sad because after 1year and a half of non sex (i've been teste poz 1 1/2 year ago) i have found a guy that a really like. I had sex with him and, protected anal sex, but we have kissed (we liked very much to kiss each other) but i was streesed about the risk. Secondly,i let him make me oral sex for 1,2 min. What is worse is that we like each other very much and i think we've just falling in love (i didn't disclosed my status). I have such bad feelings and i'm scared for him. What are the risks for him to become +? i know, there are different opinions but could the kiss be such a risky way and is it so risky that i let him 2 min to provide oral sex, i didn't come into his mouse ( i interupted him because i was scared for him) . Sorry for the language. i'm from an eastern country and i cannot find here too many advices. As you can imagine i care so much about him that i'd rather be dead than to hear that he become infected. Please, i would be grateful if you could find 1 minute to answer me. Kindly yours,

Alex

Hello Alex,

First off I must remind you and our readers that questions like these should be posted to the Safe Sex/HIV prevention Forum, not the Fatigue and Anemia Forum. I'll post this reply in both forums, but folks if you've asked a question here not related to Fatigue and Anemia, I'd strongly suggest you re-post to the correct forum to increase your chances of a reply. Thanks! OK, now back to your question. I'm glad you didn't "come into his mouse" as many mice aren't very happy about getting their tonsils spunked. Sorry I don't mean to make light of your situation. I'll be serious now. To disclose or not to disclose, and exactly when to do so are very difficult questions for us HIV pozitoids. Some folks live by the "don't ask, don't tell" rule, but always play safe. Unfortunately what one person considers "safe," someone else might consider too risky. Some folks prefer the "do ask, do tell" philosophy. Sure, this may result in getting dumped before you get humped, but wouldn't you rather know sooner rather than later that this guy is never going to be your Mr. Right? I know you are from an eastern country, but I thought I would mention that here in the US, 24 states have passed HIV-specific laws regarding disclosure. Merely exposing someone to HIV you don't have to have actually transmitted the virus can land you in jail! So in these states, as long as you know you're HIV-positive, you can be arrested just for having sex and not disclosing. These laws, as you can imagine, are extremely difficult to enforce. OK, regarding the risk of HIV transmission in your particular situation, kissing is not considered a significant risk. Oral sex carries an extremely low risk. Alex, at this point, I would strongly suggest you be honest with your new boyfriend. Waiting longer is not going to make things any less awkward. His response may surprise you, and could range from a caring heart-to-heart discussion to a cranial meltdown and wall-punching. Hopefully, he won't say either "See ya later" or "What's HIV?" also, it's probably worth noting that at this point, you don't know your boyfriend's HIV status either. It's possible he too may be positive. At any rate, if the relationship does end because he can't accept your positive status, please realize the guy is rejecting the virus, not you!

Good luck,Alex.

Dr. Bob

How and when to tell a boyfriend im hiv+ Jan 20, 2005

I have just found out i am hiv+. I am already informing past and present sex partners of this so they can be make sure they are alright. One of these guys I believe could be "the one" ive been looking for. How do I tell someone of my status and how do I deal with being rejected solely on me being hiv+?

Response from Dr. Frascino

Hi,

Sorry to hear about your recent positive diagnosis. There are no easy answers as far as exactly when and how to disclose your HIV status to your sex partners and to "the one." There are various strategies to consider, some of which I've discussed in the archives. The one strategy that I certainly don't recommend is waiting months and months to break the news. I don't believe good relationships withstand such secrecy. Consequently, I'd advise disclosing all to your honey now. If his/her status is different from yours, there are a variety of common immediate reactions that might ensue, including:

1. a caring heart-to-heart with lots of hugging and perhaps a few tears

2. "What's HIV?" (most likely if you are dating a graduate of an abstinence only sex education program)

3. a cranial meltdown and wall-punching

4. silent shock and awe

5. "See ya later." (most likely if you are dating one of those compassionate conservative Republicans)

Let's hope it's #1, but even if it's #5, just remember they are rejecting the virus, not you! Perhaps some advice form Buddha is in order (and isn't it always?): Asked how he braved his critics' insults and anger, Buddha replied, "If someone offers you a gift and you decline it, to whom does the gift belong?" I'm a bit less contemplative. If someone blows a load of rejection your way because of your HIV status, I say, "Spit, don't swallow." I wonder if I can put all that on a fortune cookie fortune?!?

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